CRNA vs. anesthesiologist

firecoins · Jul 16, 2008

If 4yrs of medical school/3yrs of residency training make MDAs better than CRNAs then provide one valid research study to prove your point.

So 2 years of RN school and 28 month CRNA training program makes CRNA equivalent to 4 years of med school and 36 month residency program? I guess AAs should also become independant.

QuestForWa · Jul 16, 2008

People, for the love of God, why is it so hard to face facts? Don't you think there are reasons for the requirements for each, CRNA and MDA?

CRNA's and MDA's are competent and capable clinicians, but there is no denying that the Med school component and it's inherent instillation of a certain method of thinking is to be so easily dismissed.

Disclaimer: I am a 24 yr old ICU RN w/ 2yrs exp. with the hope of entering CRNA school soon. I enjoy working with RNs and Dr's and other specialties(RT,PT, etc), providing they aren't arrogant or insensible, and I've seen a fair share that were from each class.

In this time I have kept my eyes, ears, and mind open to absorb EVERYTHING I could about nursing, medicine, critical care, patient interaction, and of course anesthesia. In turn I have learned much due to my own studying, but also due to my interaction with nurses AND DOCTORS of all levels. The ones that are patient and interested enough have gone into depth on issues (clotting cascade pathologies, TRUE 12 lead interpretation, sepsis markers and outcomes) have a thorough understanding and quite honestly get a little over my head by the end.

My friend since 1st grade is now done with his 2nd yr of med school. He has shown me what he is tasked with learning and knowing. It is insanely in depth! True, some of the residents will forget this stuff by the time the ICU comes around, but how many nurses can accurately recall pharmacodynamics after school? For the most part they have their knowledge bank correct and I learn something from them every day. I also just completed an advanced physiology class (using medical student text) for CRNA school and it was damn hard. The demand placed on the BSN student to learn their physio and pharm however, pales in comparison the their doctor counterparts. Point being, yes we will learn the same theories and principles, but I believe the doctors will have more depth and reinforcement on all aspects REGARDING THE PERIOPERATIVE ANESTHESIA PROCESS.

ICU work/training is invaluable. It gets an RN comfortable with necessary topics prior to CRNA school, drugs, hemodynamics, vigilance, technical interpretation. But beyond that, it's what the RN puts into it that determines what they come out with TRULY KNOWING. Seriously, my boss is concerned with the stupidest stuff ever; careplan completeness, error-free lab specimen labeling, etc. vs knowledge and "critical thinking" (i hate that phrase...) Unless I push myself I won't advance. I once caught an MI in progress on a pt. due to a subtle EKG change and behavioral change, pt went to cath lab that night and was scheduled for open heart the next day. Even the jerk Cardiologist (he really is) was impressed. However, my NURSE boss/manager the next day commented on how my tubings weren't properly dated, with no mention of what I did last night (granted, I was only doing my job). Point here is that just saying you have have "2 yrs ICU exp" means nothing if you didn't bust your butt EVERYDAY to earn it, because not many others will take you to task and make you into the quality CRNA applicant you should be.

Beyond that, I can't comment. I haven't been through CRNA school and don't know enough about MDA residency to spout off about either. But if both are rendering anesthesia in the OR when the dust settles, there has to be a good deal of consistency between the two.

The main reason for this fight to opt out and do away with the MDA is crazy. I have a feeling some of it is due to the ACT model and CRNA 's getting frustrated with that type of smothering. But for the most part, it would be good to have an MDA around. Sure, there are scenarios where the CRNA can and does do everything. But what about the ones where the pt. is deteriorating and the surgeon can't offer help, and your elder CRNA cohort(if there is one there) can't work it out either, and there is no MDA in house or on call. Then who suffers? Most of the CRNA's i've talked with and shadowed are happy with thier collaboration with the MDA's and are given a good amount of latitude, and consistently comment on how much they enjoy their job. The exception is the CRNA essentially feeling like a tech and strictly following orders. If there are any CRNA's still posting here, feel free to correct me on the above if I'm way off.

Doc Holliday: I don't believe that a CRNA is practicing under your license. Your liability from anesthesia is dependent on the extent that you choose to direct the anesthetics' delivery, whether by CRNA or MDA. On that note, it wouldn't be in your favor to order the anesthetist just to reaffirm your order on the totem pole, as that is what the tone of your comment suggested. https://www.aanafoundation.com/uploadedFiles/Resources/Legal_Briefs/2007/legalbriefsp89-93.pdf

That comment aside, Doc has been completely reasonable in his recounts and narration of his thoughts, yet people here are blatantly missing the point and looking silly, or poking their heads in to throw a jab at a doctor that "dared to come here" and give his 2 cents on the subject. His replies may be direct and unabashed, but it is the other posts that are laden with barbs.

And Dr.Nurse2b, if you are going to make a case for us, take the time to get the facts right.

CRNA: 4 yrs BSN, 1 yr ICU, 27-36 months CRNA school = 7.5-8yrs.

MDA : 4 yrs undergrad, 4 yrs med school 4 yrs Anes. residency= 12yrs.

And considering everything builds on the past, that summation factor ultimately favors the MDA.

I think only 1 CRNA school offers the DOCTORATE DNAP at this time, the others award a MASTER'S.

A CRNA is still the most fascinating and exciting role I could imagine working as. But I will know, or at least seek to know, my limitations. I don't mind having someone else around smarter than me, who may tell me I'm wrong because of something that I simply didn't have knowledge of. Think of it this way, the pt doesn't get hurt or die, and you learn something new that you will likely remember, move on... Perhaps my views will change after 10 yrs of being a CRNA, but hopefully this crap won't still be going back and forth and we can all just clam it and realize WE ALL have the opportunity to do some of the best, and most important work on the planet.

allnurses Guide · Jul 16, 2008

I know exactly what an MD/PhD is, and the point was brought up to elicit a response and to make you think about what you are saying.

You simply ignore the research when it is not in your favor......you don't like this research that has been validated over and over so you are going to blame it on bad research, but I am willing to bet you use research based findings/evidenced based research in your practice everyday. Is that all bad research???? How much of the research you use everyday has been validated again and again?

As far as the comment about being called doctor....no don't call me doctor.... I don't want to be called a doctor, and I want all my patients to know that I am nurse.

I want all my patients to know that you don't need to be physician to do this profession or need a physician supervision to be a nurse anesthetist.

By the way I think you might be confused on what MD stands for it is not Master of Divinity and I am pretty sure no where on a medical diploma does it grant divine powers or state that MDs are the only ones that have the knowledge to safely and effectively take care of patients.

You must be absolutely right.....research means nothing, but since having an MD means everything plus the duration of education means even more at least when it is combined with an MD (if I understand what you are saying) then all MDs should be under the direct supervision of MD-PhDs because obviously those two degrees together must make better clinicians.
I swear, it's like I'm talking to my two year-old.
First off, the PhD is a research degree. It is not a degree like an M.D., D.D.S., D.O., D.P.M., etc. that provides training in clinical medicine (or one of its branches). Students in MD-PhD programs want both degrees because they want to conduct research, but have the ability to combine research with patient care.
Anyways, did you not read what I said about the research to which you referred? Do you not comprehend the possibility that just because someone does research on a topic does not mean that his/her results do not necessarily produce accurate information? The very research to which you refer fails to take into account many things pertaining to the use of CRNAs in the delivery of anesthesia care, and because of it, neither I nor any of the anesthesiologists with whom I work regularly consider the research to be accurate in its conclusions--i.e. that CRNAs can do the jobs of anesthesiologists. Like I said, data can be cherry-picked to make any conclusion that you want.
As the saying goes "anesthesiologists are the only MDs that work in a nursing profession".
You know, I've heard lots of sayings. Such as "that's the way the ball bounces" or "it ain't over 'til the fat lady sings". I've even heard a saying that goes "If God didn't intend for us to eat animals, he wouldn't have made them out of meat."
But I've never heard the saying that "anesthesiologists are the only MDs that work in a nursing profession." That must be one that's used only by nurses playing make-believe, pretending to be anesthesiologists.
Good Luck in your profession DocHoliday and try not cough on any of your patients...:bowingpur
Thanks! That's wonderful advice, doctor. (You don't mind if I call you "doctor", do you?)

SuperSleeper · Jul 16, 2008

If anyone has an inferiority complex here, it is the young DocHolliday. What kind of doctor would register an account on a nursing forum just to belittle the posters?
And after reading his post, I'm convinced he hasn't even read the study he is trying to critique.
It shouldn't be surprising that CRNA's and anesthesiologists have similar patient outcomes. With the improved anesthetics and monitoring equipment, anesthesia is much safer these days. Accidents are most commonly from lack of attention, not lack of education.

Thank you!

DocHolliday · Jul 16, 2008

My friend since 1st grade is now done with his 2nd yr of med school. He has shown me what he is tasked with learning and knowing. It is insanely in depth! True, some of the residents will forget this stuff by the time the ICU comes around, but how many nurses can accurately recall pharmacodynamics after school? For the most part they have their knowledge bank correct and I learn something from them every day. I also just completed an advanced physiology class (using medical student text) for CRNA school and it was damn hard. The demand placed on the BSN student to learn their physio and pharm however, pales in comparison the their doctor counterparts. Point being, yes we will learn the same theories and principles, but I believe the doctors will have more depth and reinforcement on all aspects REGARDING THE PERIOPERATIVE ANESTHESIA PROCESS.

The main reason for this fight to opt out and do away with the MDA is crazy. I have a feeling some of it is due to the ACT model and CRNA 's getting frustrated with that type of smothering. But for the most part, it would be good to have an MDA around. Sure, there are scenarios where the CRNA can and does do everything. But what about the ones where the pt. is deteriorating and the surgeon can't offer help, and your elder CRNA cohort(if there is one there) can't work it out either, and there is no MDA in house or on call. Then who suffers? Most of the CRNA's i've talked with and shadowed are happy with thier collaboration with the MDA's and are given a good amount of latitude, and consistently comment on how much they enjoy their job. The exception is the CRNA essentially feeling like a tech and strictly following orders. If there are any CRNA's still posting here, feel free to correct me on the above if I'm way off.

I don't think anyone should treat a CRNA like a tech. And I certainly hope anesthesiologists don't either. They do have some troubleshooting abilities. What concerns me, though, from reading many of the posts from the CRNAs here is that they think they know everything an anesthesiologist does. People who think they know everything there is to know are the most dangerous people to deliver health care. They are far more likely to resist outside help.

Doc Holliday: I don't believe that a CRNA is practicing under your license. Your liability from anesthesia is dependent on the extent that you choose to direct the anesthetics' delivery, whether by CRNA or MDA. On that note, it wouldn't be in your favor to order the anesthetist just to reaffirm your order on the totem pole, as that is what the tone of your comment suggested. https://www.aanafoundation.com/uploa...iefsp89-93.pdf

I made that comment to which you refer simply to make a point. The CRNA, at least where I work, IS working under my license. If he/she screws up, I bear some of the blame.

In reality, it is rare that I talk to the CRNA (or anesthesiologist) about the anesthesia plan. Occasionally I request muscle relaxants, or let them know that the patient isn't anesthetized deeply enough, but that's about it.

That comment aside, Doc has been completely reasonable in his recounts and narration of his thoughts, yet people here are blatantly missing the point and looking silly, or poking their heads in to throw a jab at a doctor that "dared to come here" and give his 2 cents on the subject. His replies may be direct and unabashed, but it is the other posts that are laden with barbs.

And Dr.Nurse2b, if you are going to make a case for us, take the time to get the facts right.

CRNA: 4 yrs BSN, 1 yr ICU, 27-36 months CRNA school = 7.5-8yrs.

MDA : 4 yrs undergrad, 4 yrs med school 4 yrs Anes. residency= 12yrs.

I would also add to that the different nature of medical school from nursing school. Again, medical school creates physicians. Nursing school, on the other hand, creates nurses. From there, it is simply impossible for the two different entities to go on to receive the same training and same qualifications to provide anesthesia services.

And considering everything builds on the past, that summation factor ultimately favors the MDA.

Precisely! I cannot believe it. Someone finally understood what I was trying to say (and stated it far more succinctly than I could have). More background knowledge gives you a better, more thorough understanding of what you are currently studying. I remember, there were a few of my classmates in medical school who majored in disciplines other than biology. That means they did not have the physiology, endocrinology, cell biology courses, etc., that most of us had. They did not fare as well as the rest of us. They did well enough, but the courses in medical school were tougher for them.

I think only 1 CRNA school offers the DOCTORATE DNAP at this time, the others award a MASTER'S.

A CRNA is still the most fascinating and exciting role I could imagine working as. But I will know, or at least seek to know, my limitations. I don't mind having someone else around smarter than me, who may tell me I'm wrong because of something that I simply didn't have knowledge of. Think of it this way, the pt doesn't get hurt or die, and you learn something new that you will likely remember, move on... Perhaps my views will change after 10 yrs of being a CRNA, but hopefully this crap won't still be going back and forth and we can all just clam it and realize WE ALL have the opportunity to do some of the best, and most important work on the planet.

QuestforWa, make no mistake about it. The doctors around you are not necessarily smarter. I have never assumed that any of the mid-levels with whom I work, nor the nurses caring for my patients on the floor, are somehow less intelligent than me. Less educated about medicine, yes. Less intelligent....who knows? Maybe they all have higher IQs than I do!

DocHolliday · Jul 16, 2008

So 2 years of RN school and 28 month CRNA training program makes CRNA equivalent to 4 years of med school and 36 month residency program? I guess AAs should also become independant.

I know exactly what an MD/PhD is, and the point was brought up to elicit a response and to make you think about what you are saying.
You simply ignore the research when it is not in your favor......you don't like this research that has been validated over and over so you are going to blame it on bad research, but I am willing to bet you use research based findings/evidenced based research in your practice everyday. Is that all bad research???? How much of the research you use everyday has been validated again and again?
As far as the comment about being called doctor....no don't call me doctor.... I don't want to be called a doctor, and I want all my patients to know that I am nurse.
I want all my patients to know that you don't need to be physician to do this profession or need a physician supervision to be a nurse anesthetist.
By the way I think you might be confused on what MD stands for it is not Master of Divinity and I am pretty sure no where on a medical diploma does it grant divine powers or state that MDs are the only ones that have the knowledge to safely and effectively take care of patients.

This profession? This profession?

You don't make any distinction whatsoever between CRNAs and anesthesiologists. You think they are identical entities, except with different degrees.

As for your M.D., Ph.D. point, I know what you were trying to do, but it was a lousy example. There is no degree above an M.D. (or a D.O., D.D.S., D.P.M., or any other doctoral degree) that bestows upon someone any supervisory role. Once you have earned a doctoral degree, anyone who has any supervisory role over you does so because they have been appointed head of a department, or because they own the entire business. Again, your MD/PhD example was a poor one.

Finally, I am not ignoring the research to which you refer. I am questioning their implied assertions that there is no difference between CRNAs and anesthesiologists.

Just FYI, here's a study that showed that anesthesia services are better when anesthesiologists are involved:

http://www.ncbi.nlm.nih.gov/pubmed/10861159?dopt=Abstract

The study found the following:

"2.5 excess deaths/1,000 patients and 6.9 excess failures-to-rescue (deaths) per 1,000 patients with complications" when anesthesia services weren't directed by anesthesiologists.

Did you see me throw this article in your face and claim it to be proof that I'm right, as you did with your pro-CRNA research references? It certainly would have been useful to my argument, but I omitted it because, just like the research to which YOU refer, it has some deficiencies.

So, instead, I am going by what is an obvious difference between CRNAs and anesthesiologists: education and training. Anesthesiologists have superior knowledge and superior training, and that makes them better.

You know, come to think of it, I did have one bad experience with a CRNA. I was in the OR, performing an open reduction of a fractured mandible, and the patient's masticator muscles were flexing and preventing me from reducing the fracture.

So, I told the CRNA that I needed the patient more relaxed (i.e. paralyzed) becuase I couldn't approximate the bone ends.

The CRNA responded with a smart-alec comment, saying "We don't have bone relaxers". I know she was not being sarcastic or making jokes, because I had to inform her of the fact that the muscles were pulling the bone apart. After I told her, her response was a somewhat surprised, "Oh, oh. Ok".

Does this experience shape my view of CRNAs? Of course not. But it does--and rightfully so--raise an eyebrow. I've never heard such an idiotic comment from an anesthesiologist in similar situations, nor would I ever expect to hear such a thing from them.

Natef26 · Jul 16, 2008

ZZZzzzzzzz

allnurses Guide · Jul 16, 2008

lol....I was wondering if someone was ever going to bring up the notorious Silber study....the study that was so bad that only the ASA would publish it (not to say that ASA normally publishes bad studies on a routine basis, but this was nothing more than politics by the ASA)... Anyways, here is what AANA and others had to say about that study.

"Quality of Care in Anesthesia

Section Two

Anesthesiologist Distortions Concerning Quality of Care

2. Silber Study in Medical Care

[silber, JH, Williams, SV, Krakauer, H, Schwartz, JS. "Hospital and Patient Characteristics Associated With Death After Surgery. A Study of Adverse Occurrence and Failure to Rescue." Medical Care. 1992;30:615.1

The Silber study examined the death rate, adverse occurrence rate, and failure rate of 5,972 Medicare patients undergoing two fairly low-risk procedures--elective cholecystectomy and transurethral prostatectomy. The study did not discuss any anesthesia provider except physician anesthesiologists; the study did not even mention CRNAs. The study, therefore, had nothing to do with CRNAs and did not compare the outcomes of care of nurse anesthetists to those of anesthesiologists. The study did not address any aspect of CRNA practice; it certainly did not explore the issue of whether CRNAs should be physician supervised.

The Silber study was a pilot study, i.e., a study to demonstrate the feasibility of performing a more definitive study concerning patients developing medical complications following surgery. It would be inappropriate to formulate public policy based on the Silber study; the study does not address CRNAs, and cannot be considered conclusive even about the issues that it does address. The Silber study states, at page 625:

This pilot project examined ideas that, to our knowledge, have not been examined previously, and more work is needed before the full significance of the results can be determined. It is especially appropriate, therefore, that the limitations of the project be recognized.

At most, the study's conclusions support the proposition that certain facilities would benefit from having a board-certified anesthesiologist in the Intensive Care Unit. This might result in the "rescue" of some patients who have undergone elective cholecystectomies and transurethral prostatectomies and developed life-threatening postoperative complications. The Silber study's conclusions have nothing to do with nurse anesthetists or the nature of who may supervise, direct, or collaborate with nurse anesthetists. At most, the study concluded that anesthesiologists may play a clinically valuable role in caring for postoperative complications. The study, however, did not involve examination of the outcomes of anesthesia in the operating room.

In his analysis of the Silber study, Dr. Michael Pine (physician and expert in quality and health care) stated that:

Thus, the presence of board-certified anesthesiologists does not appear to lower the rate of complications, either alone or in combination with other factors such as high technology. It is not anesthesia care but the failure to rescue patients once complications occur which contributes to the death rate. On the other hand, unmeasured factors such as a higher percentage of other board-certified physicians in the hospital, also may account for the better outcomes. The conclusion to be drawn from this study is that, although the presence of board-certified anesthesiologists may not make a difference in the operating room, it may make a difference in the failure to rescue patients from death or adverse occurrences after postoperative complications have arisen. This conclusion is in keeping with the expanded role that anesthesiologists have identified for themselves in post-operative care....

Dr. Pine went on to conclude, in pertinent part, regarding the Silber study that:

"1. This study encompassed the entire period of operative and postoperative care and was not specific to anesthesia staffing.

2. The rate of deaths possibly attributable to anesthesia care is a negligible fraction of the death rate found in this study.

3. The factors that significantly affect mortality and are most amenable to clinical interventions arise during postoperative management, not during the administration of anesthesia.

4. The type of anesthesia provider does not appear to be a significant factor in the occurrence of potentially lethal complications. If anything, this study suggests that surgical skill is more important.

5. The presence of board-certified specialists does appear to make an important difference in post-surgical care."

Pennsylvania anesthesiologists have unsuccessfully attempted to use the Silber study as a justification for a restrictive regulation they have urged the state's board of medicine to adopt. While the board proposed the regulation, it has not adopted it. Reportedly, the board decided at a March 1998 meeting to withdraw the proposal. The proposed regulation would have required physicians who delegate duties to CRNAs to have qualifications that only anesthesiologists typically possess. The practical effect would have been to require CRNAs to be anesthesiologist supervised in every practice setting.

Significantly, the Independent Regulatory Review Commission (IRRC), a Pennsylvania oversight commission that reviews health care proposals, carefully evaluated the Silber study, and issued a report rejecting the study as any basis for requiring anesthesiologist supervision of CRNAs. The IRRC stated that:

Based on our review of the 1992 Medical Care article, we have concluded, as its authors clearly state, it is a preliminary study and that caution should be taken in making any definitive conclusions. More importantly, the authors did not consider the scenario of an operating physician delegating the administration of anesthesia to a CRNA, or what expertise the operating physician should have in order to safely delegate anesthesia to a CRNA. Therefore, we do not believe this study should be used as justification for the significant change in practice for the administration of anesthesia.The IRRC further stated that:

There have been two studies, both completed over 20 years ago, that compared the outcomes of anesthesia services provided by a nurse anesthetist and an anesthesiologist. Neither of these studies concluded that there was any statistically significant difference in outcomes between the two providers. This conclusion was also reached by the Minnesota Department of Health, which recently completed a study on the provision of anesthesia services. In fact, most studies on anesthesia care have shown that adverse outcomes and deaths resulting from anesthesia has decreased significantly in the last several decades as [a] result of improved drugs and monitoring technology." http://www.aana.com/resources.aspx?ucNavMenu_TSMenuTargetID=51&ucNavMenu_TSMenuTargetType=4&ucNavMenu_TSMenuID=6&id=673

Just FYI, here's a study that showed that anesthesia services are better when anesthesiologists are involved:
http://www.ncbi.nlm.nih.gov/pubmed/10861159?dopt=Abstract
The study found the following:
"2.5 excess deaths/1,000 patients and 6.9 excess failures-to-rescue (deaths) per 1,000 patients with complications" when anesthesia services weren't directed by anesthesiologists.
Did you see me throw this article in your face and claim it to be proof that I'm right, as you did with your pro-CRNA research references? It certainly would have been useful to my argument, but I omitted it because, just like the research to which YOU refer, it has some deficiencies.
So, instead, I am going by what is an obvious difference between CRNAs and anesthesiologists: education and training. Anesthesiologists have superior knowledge and superior training, and that makes them better.
You know, come to think of it, I did have one bad experience with a CRNA. I was in the OR, performing an open reduction of a fractured mandible, and the patient's masticator muscles were flexing and preventing me from reducing the fracture.
So, I told the CRNA that I needed the patient more relaxed (i.e. paralyzed) becuase I couldn't approximate the bone ends.
The CRNA responded with a smart-alec comment, saying "We don't have bone relaxers". I know she was not being sarcastic or making jokes, because I had to inform her of the fact that the muscles were pulling the bone apart. After I told her, her response was a somewhat surprised, "Oh, oh. Ok".
Does this experience shape my view of CRNAs? Of course not. But it does--and rightfully so--raise an eyebrow. I've never heard such an idiotic comment from an anesthesiologist in similar situations, nor would I ever expect to hear such a thing from them.

lsufan · Jul 16, 2008

DocHolliday,

Come on, I mean really, enough already. Go pick up some extra call or something, please find something better to do with your time, this is becoming pathetic. Better yet, why don't you stalk down a Surgical Tech website and argue the difference between a surgeon and a scrub tech?

DocHolliday · Jul 17, 2008

At most, the study's conclusions support the proposition that certain facilities would benefit from having a board-certified anesthesiologist in the Intensive Care Unit. This might result in the "rescue" of some patients who have undergone elective cholecystectomies and transurethral prostatectomies and developed life-threatening postoperative complications. The Silber study's conclusions have nothing to do with nurse anesthetists or the nature of who may supervise, direct, or collaborate with nurse anesthetists. At most, the study concluded that anesthesiologists may play a clinically valuable role in caring for postoperative complications. The study, however, did not involve examination of the outcomes of anesthesia in the operating room.

WTBCRNA....

First off, as a physician, I am not particularly interested in what the AANA thinks about a study. Nurse anesthetists and their governing bodies are not an authority on the practice of anesthesia. Anesthesiologists and the ASA are.

Moreover, even if what you said above were the only thing the Silber study rightfully demonstrated, that in itself is proof that CRNAs cannot be left alone without some sort of drop in quality of care under certain circumstances.

Nobody's saying that CRNAs aren't able to handle routine anesthesia (and yes, "routine" complications). What I am saying, and what anesthesiologists are saying is that it's the complicated things they are not as qualified to handle as anesthesiologists are.

I mean, do you just flat-out refuse to accept that a physician with four more years of training than you knows a thing or two more about the practice of anesthesia and its associated sciences? You think that you, a nurse who spent 28 months in an anesthesia masters program, is going to have the same scope and depth of knowledge as a physician who spent 48 months in a residency program?

The conclusion to be drawn from this study is that, although the presence of board-certified anesthesiologists may not make a difference in the operating room, it may make a difference in the failure to rescue patients from death or adverse occurrences after postoperative complications have arisen. This conclusion is in keeping with the expanded role that anesthesiologists have identified for themselves in post-operative care....

My point exactly. Anesthesiologists, because they are physicians who have, unlike CRNAs, intimate knowledge of human health and disease, are better able to manage complicated situations.

This Dr. Pine character certainly is splitting hairs, isn't he. Like you (and other CRNAs), he seems to view "anesthesia" as pumping some poor sap full of Diprivan, sticking a tube down their trachea, cranking up the gasses, then turning everything off and extubating when the procedure is done, and making sure the patient is waking normally inthe PACU. After that, according to Dr. Pine, the provider administering the anesthesia can dust off his or her hands, because he or she is done and no longer responsible.

Well, anesthesia is a little broader in scope than that which CRNAs are trained for....as the Silber study seems to demonstrate.

hbgwan, LPN, LVN · Jul 17, 2008

DocHolliday,
Come on, I mean really, enough already. Go pick up some extra call or something, please find something better to do with your time, this is becoming pathetic. Better yet, why don't you stalk down a Surgical Tech website and argue the difference between a surgeon and a scrub tech?

ladies and gentlemen, we have a winner! well said, lsufan!!!! props.

Natef26 · Jul 17, 2008

DocHolliday,
Come on, I mean really, enough already. Go pick up some extra call or something, please find something better to do with your time, this is becoming pathetic. Better yet, why don't you stalk down a Surgical Tech website and argue the difference between a surgeon and a scrub tech?

Ditto. I can only WISH I had the free time DocHolliday apparently has!